What Is Comorbid Depression?
There are many terms used when discussing depression. For this reason, some people may get confused about what types of depression are associated with what terms. One of these terms is comorbidity, which can explain the connection between depression and other mental health conditions. Understanding comorbidity may help you understand your treatment plan, make informed treatment decisions, and treat your unique symptoms if you live with a mental illness like depression.
What is comorbidity?
Some may connect the term “morbidity” with a gloomy demeanor or an affinity for dark subjects like death or violence. However, morbidity, by definition, refers to experiencing the symptoms of a disease or condition. In psychology, the term “comorbidity” refers to the presence of more than one disease, condition, or disorder simultaneously.
The presence of comorbidity in any disorder, physical or mental, can increase the likelihood of a misdiagnosis. For example, anxiety symptoms can be confused with symptoms of a medical condition like adrenal dysfunction or cardiovascular disease, and depression symptoms can be confused with symptoms of anemia or hypothyroidism.
Comorbidity also increases the complexity of diagnosis and treatment, especially when working with medications. For example, individuals diagnosed with depression may also live with bipolar disorder or other mood disorders requiring specific medications. Substance use disorders are commonly comorbid with depressive disorders and are often treated differently.
Comorbidity between depression and anxiety
Any mental or physical illness can present as a comorbidity for depression. However, the most common conditions alongside depressive disorders are anxiety disorders, particularly generalized anxiety disorder (GAD) and panic disorder. The relationship is bi-directional; statistics suggest roughly 60% of people with depression present comorbid symptoms of anxiety disorders, and vice versa.
The reasons for this relationship are thought to be behavioral and cognitive, but some studies point to a physiological connection as well. Anxiety and depression often feature the same chemical imbalances, so similar medications may be effective in treating both disorders.
The symptoms of anxiety and depression are often connected. Depression can cause a lack of motivation and difficulty engaging in previously enjoyed activities. When a person experiencing depression has this symptom, they may shirk commitments and responsibilities. Due to the consequences of avoidance behaviors, an individual may then experience severe anxiety. Similarly, anxiety can make everyday tasks overwhelming and complicated, leading to increased depression or avoidance.
Other common depression comorbidities
Several mental and physical health conditions can be comorbid with depression, including but not limited to the following:
- Obsessive-compulsive disorder (OCD)
- Substance use disorder
- Post-traumatic stress disorder (PTSD)
- Personality disorders
- Dementia
- Stroke
- Cancer
What are the symptoms of depression?
Not to be confused with grief, bereavement, or sadness, depression doesn’t involve a process that an individual can “get over.” This condition often affects people at the core of their perceptions of self-worth. When left untreated, depression doesn’t go away on its own. When unaddressed, symptoms often evolve into more serious mental health challenges, increasing the likelihood of comorbidity.
Depression is one of the most common psychological disorders, affecting an estimated one in six adults at some point in their lives. According to the Diagnostic Manual of Mental Health Disorders, symptoms of depression often vary from mild to severe and must last two weeks or more. Symptoms cause difficulties in daily life and impair a person’s ability to function normally. Below are several of the most common symptoms:
- Feelings of guilt or shame
- Thoughts of hopelessness and worthlessness
- Intense sadness and a low mood
- Physical pain, including gastrointestinal distress and headaches
- Loss of interest and enjoyment in activities that once brought pleasure
- Sleep disruptions
- Appetite changes
- Difficulty concentrating
- Loss of energy
- Thoughts of death or suicide
If you are experiencing suicidal thoughts or urges, call the 988 Suicide & Crisis Lifeline at 988 or text 988 to talk to a crisis provider over SMS. They are available 24/7 to offer support. 988 also offers an online chat for those with an internet connection.
Note that medical conditions like thyroid conditions or vitamin deficiencies can also mimic symptoms of depression, so speak to a doctor to rule out general medical causes.
Risk factors for depression
While depression can occur at any age, it most commonly appears in the late teens to mid-20s. Women are twice as likely to develop depression than men, and the condition is inheritable. Beyond these factors, there are a few other causes of depression, including the following:
- Childhood trauma or post-traumatic stress disorder
- Stressful life events
- Low self-worth or pessimism
- Substance use
- Chronic health conditions
Diagnosing depression with comorbidities
The diagnostic process for many mental and physical health conditions often begins with a physical exam and health evaluation. Your doctor may ask about your family history and order lab work to rule out any underlying physical cause. From there, your doctor may refer you to a mental health professional for an evaluation.
When you meet with a therapist for the first time, they may ask about your symptoms, thoughts, behavior patterns, and feelings. You might also be asked to take a self-assessment questionnaire to supplement these questions during this meeting. Your therapist may also request to speak to your other healthcare providers using a release form with your consent. After the preliminary assessment, your mental health professional can compare the information they obtained about your case with the criteria for depression and any suspected comorbidities listed in the DSM-5.
How is depression with comorbidities treated?
Treatments for depression with comorbidity can depend on the specifics of your condition. You may undergo a psychotherapeutic treatment such as cognitive-behavioral therapy (CBT) or one of over 400 other modalities. Your therapist can work with you to determine how many sessions you partake in and how often. This treatment plan may change with time and circumstances.
In addition to therapy, your therapist may wish to consult your doctor or psychiatrist to talk about treatment notes. Note that therapists cannot prescribe medication or offer medication management as they are not medical doctors. For this reason, some people have a treatment team instead of working with one person. Medications for depression are often highly effective alongside therapy. However, consult your doctor before starting, changing, or stopping a medication.
Alternative support options
Although it can be vital to treat depression as soon as possible, some people don’t seek help. The causes of avoiding support are varied and may include a lack of therapists in the area or difficulty commuting to and from appointments. Some people have a demanding schedule, making finding time to attend and commute to appointments challenging. Others may be unable to afford therapy or are self-conscious about talking to someone about their challenges.
Finding a therapist through an online platform like BetterHelp can be an effective solution to overcoming these barriers. Online therapy is convenient, affordable, and often as effective as online therapy. For example, one meta-analysis cultivated findings from 64 trials measuring the effectiveness of online therapy vs. traditional therapy. Researchers reported that virtual therapy could be as effective as in-person therapy in treating anxiety and depression.
Online therapists are licensed, accredited, and experienced in treating anxiety and depression. You can schedule appointments when it’s convenient for you. In addition, if you require support from your therapist in-between appointments, you can message them throughout the week and receive responses when they’re available.
Takeaway
What is a comorbid mental illness?
A comorbid mental illness is one that occurs simultaneously with another illness in the same individual. Comorbid illnesses may also be referred to as concurrent diagnoses. For example, depression is often comorbid with insomnia—or in other words, someone with depression could also experience insomnia at the same time. Another example is that post-traumatic stress disorder (PTSD) is often comorbid with substance use disorders of drugs or alcohol.
Some comorbid disorders also have overlapping symptoms, like a tendency toward risky behaviors in both PTSD and substance use disorders, for example. In addition, sometimes one treatment can be helpful for both, such as cognitive behavioral therapy for both depression and insomnia or antidepressants for both depression and anxiety. Understanding the commonly comorbid conditions of various disorders can help with both prevention and treatment for individual patients and within the broader health care system.
What is the most common comorbidity of major depressive disorder?
One of the most common comorbidities with major depressive disorder is thought to be generalized anxiety disorder or other anxiety disorders. As research suggests from the National Alliance on Mental Illness, around 60% of those who are living with depression also experience symptoms of an anxiety disorder, and statistics are similar for the reverse as well. Comorbid anxiety and depression may present additional challenges compared to an instance of only one disorder or the other, but both are considered treatable with professional mental health support.
What's comorbid anxiety?
Comorbid anxiety refers to an anxiety disorder that manifests in an individual who is already living with another illness. For example, both anxiety and depression could occur in the same individual at the same time. You could say that the individual experiencing depression has comorbid anxiety, or that the individual experiencing anxiety has comorbid depression.
Is depression a comorbid disorder?
Depression is a comorbid disorder when it occurs at the same time as another condition within the same individual. It’s commonly seen in conjunction with other disorders such as anxiety disorders, substance use disorders, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD), among others. Depression is also commonly comorbid with physical health conditions, such as diabetes, Parkinson’s disease, and cancer.
What group is most at risk for depression?
Recent statistics suggest that young people are currently experiencing depression at the highest rates. Other groups may also be at increased risk of developing depression, such as pregnant people, those who have experienced abuse or past trauma, or those who already have another chronic mental or physical health condition.
If you or someone you know is experiencing abuse in any form, you can contact the National Domestic Violence Hotline at 1-800-799-SAFE (7233) for immediate support, advice, and assistance.
What is the most depressing age?
No age is more inherently “depressing” than another. However, some phases of life may come with an increased likelihood of certain risk factors that could boost a person’s chances of developing a mental health condition like depression. For example, older adults may be more likely to experience chronic loneliness, which can make them more likely to experience depression.
Is depression curable or just treatable?
In most cases, depression is considered treatable rather than curable. This means that although a person may continue to experience symptoms from time to time throughout their life, these symptoms can usually be effectively managed so as to not significantly interfere with daily functioning.
Treatment for depression usually involves some form of talk therapy—whether on an individual basis or in the form of support groups—and sometimes in combination with medication. Clinicians who provide talk therapy and/or psychiatry services can advise an individual on which type of treatment might be best for their unique situation.
Who is more prone to depression and anxiety?
There are various risk factors that could increase a person’s likelihood of developing depression or anxiety. Some include genetics, past trauma, stressful life events, grief, substance use, and certain lifestyle factors such as social isolation or a lack of exercise, among others.
What are comorbid depressive symptoms?
Comorbid depressive symptoms are symptoms of depression that may appear in an individual who already has another health condition. For example, someone who already has insomnia could begin to experience comorbid depressive symptoms, since depression and insomnia are conditions with a high rate of comorbidity.
How often is depression comorbid?
As a research paper from 2020 suggests, around 50–60% of individuals who experienced depression over their lifetime also experienced at least one anxiety disorder. It also reports that over 18% of survey respondents who indicated experiencing major depressive disorder in the past year also experienced a substance use disorder of some kind. Depression can also occur comorbidly with a variety of other mental illnesses as well as physical health conditions, meaning that it has a generally high comorbidity rate.
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